Dutch doctors warn parents over whooping cough vaccine

Mr Clifford's posting is bunkum.

I took the trouble to read the reference he gives - which oddly enough turns out to be a rapid response by him and his argument there boils down to an assertion that the law is better at deciding scientific issues than any scientific process since it allows anyone who can get together 1000 people to say that something is so, to carry the day.

Rubbish.

The threat that unless we go through the whole of the evidence (surely not scientific evidence Mr Clifford, since your advice is that this is of no value outside a scientific experiment) with each individual parent and list every item of that advice for later inspection one of his erudite and estimable colleagues will sue us for negligence and personal injury is unconvincing.

Some things are best done individually, and some are best done by society. Immunisation, in general and in bulk, where the same is expected to be given to each person is one of the latter.

(Indeed, the process by which society arrives at such decisions has the elements that Mr Clifford offers as valuable - time for discussion, access for anyone to discuss it. It is clear that the result of those discussions has been that society prefers the scientific and medical view.)

Actual History

The history of vaccination might be interesting here as well. The assertion that scientific investigation ignores what people know and say does not fit with the observation that dairymaids who had previously contracted cowpox were later immune to smallpox.

This lead to the deliberate induction of cowpox, which produced immunity to Smallpox before exposure, and consequently made survival more likely.

Similarly, in this country, Paralytic Polio was talked about widely, as was the fact after the introduction of immunisation with killed and then live viruses that paralytic Polio became rare and is now almost non-existent.

Evil and Liability

What is also clear is that various people and groups for their own reasons seek to muddle parents, resulting in the persistence and recrudescence of Polio in some African countries recently and in this country in persistent vulnerability of some children, not all of them children of parents who make a deliberate decision to not immunise them.

I would suggest that the position of anyone who an injured child can convince a court persuaded his parent to refrain from protecting him is in far more jeopardy than that of a GP or other healthcare professional who has been acting in accordance with the large body of opinion backed up by a scientific basis for belief in the effectiveness of the treatment.

In fact I am disappointed that no newspaper nor anti-immunisation activist has yet been hauled befor the courts to account for their actions in respect of an individual afflicted by a preventable disease.

Competing interests:
None declared

Obtaining valid consent for an elective intervention like vaccination
includes informing parents/guardians/patients of even remote recognised
risks in a timely manner and reliably documenting same - as well as
informing them of the benefits, particularly should they decide not to
vaccinate, and documenting same. For those to be vaccinated, I suggest
giving parents/guardians/adult patients the manufacturers patient
information sheets that accompany the vaccine packaging in advance,
assuming they can read, and documenting what was given. For infant
vaccines this would be at the time of the two or six week check. The
MMR/travel/other vaccine sheets should be given at the time of making the
appointment for vaccination as information supplied too far in advance of
an elective procedure (or just before) may be deemed untimely and
invalid.

On returning for vaccination any questions/concerns of
parents/guardians/patients can be addressed prior to signing a consent
form, which should confirm that current manufacturers information sheets
were supplied and that Dr.XY explained the content (Dr. XY also signing
the consent form). We have practiced this for some time using a proforma
consent sheet with a list of all vaccines, relevant ones to be ticked. It
is rarely time consuming, and I suspect would involve a most appropriate
party in the event of a challenge - the manufacturer.

Competing interests:
None declared